'Patient safety at risk because of poor hand-washing in one of the most overcrowded hospitals' - Hiqa
Patient safety is at risk because of poor hand-washing and other infection control weaknesses in one of the most overcrowded hospitals in the country, according to a new watchdog report.
The report from Hiqa revealed inspectors had to deliver a formal warning to Our Lady of Lourdes Hospital in Drogheda in June and follow up with another visit in July.
The inspectors had particular concern about the infection risks to patients from legionella at the hospital.
The follow-up inspection found improvements were made but there are ongoing risks, compounded by the constant influx of patients at the hospital.
The risks related to levels of handwashing among staff, the giving of injections and the care of patient equipment.
In response a spokesman for the hospital said today that it acknowledges the issues raised in the report.
He said :”Our Lady of Lourdes Hospital Drogheda welcomes the HIQA’s acknowledgement in the report of the improvements and progress made by the hospital management team and staff in respect of all issues raised on their initial visit.
“The hospital has a robust governance structure in place for the management of all aspects of the National Standards for the Prevention and Control of Healthcare Associated Infections. The hospital has developed a quality improvement plan to address the remaining outstanding issues raised in the report.
“The Hospital would like to provide the following clarification regarding the specific issue raised in the report pertaining to the control of Legionella risk.
“Legionella is a gram negative bacterium that is common in many soil and water systems and can give rise to infection in humans. Inpatients in hospital, particularly those with impaired immunity are at higher risk. For this reason Our Lady of Lourdes Hospital has a robust system of actively managing all of the processes that minimise the likelihood of Legionella bacteria in the water supply.
“This is to ensure a high level of protection to all patients and staff. The Hospital is compliant with the Legionella L10 international Code of Practice”
- Water quality management is monitored and governed by the Louth Hospital Environmental Management Committee. This is a multidisciplinary group including a Consultant Microbiologist.
- There have been no hospital acquired infections associated with Legionella bacteria in Our Lady of Lourdes Hospital.
- The hospital has engineered solutions in place to ensure the quality of water supply including Copper Silver treatment of water to eliminate Legionella bacteria. This has been in place for the last four years.
- In addition regular flushing of all low use outlets is in place on a daily basis.
- We have an ongoing process to measure the efficacy of this treatment process with monthly sampling of water to ensure adequate levels of this treatment process at point of use.
- In circumstances where diminished levels of copper silver are identified remedial works have been undertaken to rectify this. Three such locations (taps, sink and bath) were identified within the last year. The reason for this has been identified in all cases and rectified.
- Subsequent sampling (August 2015) by an external and independent accredited agency has confirmed all areas are now compliant.
- Furthermore there is additional external independent sampling of water supply for Legionella in accordance with the National Standard. The national standard is twice yearly testing. In Our Lady of Lourdes, monthly random testing at point of water supply is undertaken. Within the last year, three samples have returned with a bacterial level higher than accepted norms. In all cases the reasons for this have been identified and remedial action has taken place.
- Hospital Shower heads were removed a number of years ago, prior to the installation of our Copper Silver Treatment of water as they were considered to cause increase risk of spread of the bacteria. These have now been replaced in line with best evidenced based practice.
The spokesman added:”The hospital is eager to point out that there is an effective process in place that ensures there is an adequate supply of mop heads and vacuum cleaners for each ward at all times.
"HIQA concerns arising on the day of the inspection on this matter relate to a single incident where there was a lack of awareness of the well-established process that is in place.
“It l has also taken other steps to address issues arising from the report including completing minor maintenance works, risk assessment in relation to access to sinks, and improvements with regard to staff training, audit and information display to ensure compliance with hygiene standards.”